International Journal of Medical Sciences

Impact factor
2.399

23 October 2017

ISSN 1449-1907 News feeds of published articles

My Manuscript | My Account

Journal of Genomics now in PubMed/PubMed Central. Submit manuscript...

Journal of Biomedicinenew

Theranostics

Journal of Cancer

Oncomedicine

International Journal of Biological Sciences

Journal of Genomics

Journal of Bone and Joint Infection (JBJI)

Nanotheranostics

PubMed Central Indexed in Journal Impact Factor

Int J Med Sci 2015; 12(5):378-386. doi:10.7150/ijms.11224

Research Paper

Reduction of QTD - A Novel Marker of Successful Reperfusion in NSTEMI. Pathophysiologic Insights by CMR

Christoph J. Jensen1✉, Sarah Lusebrink1, Alexander Wolf1, Thomas Schlosser2, Kai Nassenstein2, Christoph K. Naber1, Georg V. Sabin1, Oliver Bruder1

1. Contilia Heart and Vascular Center, Department of Cardiology and Angiology, Elisabeth Hospital Essen, Germany;
2. Department of Diagnostic and Interventional Radiology and Neuroradiology, University of Essen, Germany.

Abstract

Background/Objectives: Non-ST segment elevation myocardial infarction (MI) poses similar detrimental long-term prognosis as ST-segment elevation MI. No marker on ECG is established to predict successful reperfusion in NSTEMI. QT dispersion is increased by myocardial ischemia and reduced by successful restoration of epicardial blood flow by PCI. Whether QT dispersion reduction translates to smaller infarcts and thus indicates successful reperfusion is unknown.

We hypothesized that the relative reduction of QT dispersion (QTD-Rrel ) on a standard ECG in acutely reperfused NSTEMI is related to infarct size and infarct transmurality as assessed by delayed enhancement CMR (DE-CMR).

Methods and Results: 69 patients with a first acute NSTEMI were included. QTD-Rrel was stratified according to LV function and volumes, infarct transmurality and size as assessed by DE-CMR. Extensive myocardial infarction was defined as above median infarct size.

LV function and end-systolic volume were only mildly related to QTD-Rrel . QTD-Rrel was inversely related to infarct size (r=-0.506,p=0.001) and infarct transmurality (r=-0.415, p=0.001). QTD-Rrel was associated with extensive myocardial infarction in univariate analysis (odds ratio (OR) 0.958, CI 0.935-0.982; p=0.001). Compared to clinical and angiographic data QTD-Rrel remained the only independent predictor of non-transmural infarcts (OR 1.110, CI 1.055-1.167; p=0.049).

Conclusion: In patients with acute Non-ST-Segment Myocardial infarction QTd-Rrel calculated on a surface ECG prior and post PCI for restoration of epicardial blood flow detects small, non-transmural infarcts as assessed by delayed enhancement CMR. Thus, QTd-Rrel can indicate successful reperfusion therapy.

Keywords: acute myocardial infarction, non-ST-elevation myocardial infarction, QT dispersion, cardiac magnetic resonance imaging.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Jensen CJ, Lusebrink S, Wolf A, Schlosser T, Nassenstein K, Naber CK, Sabin GV, Bruder O. Reduction of QTD - A Novel Marker of Successful Reperfusion in NSTEMI. Pathophysiologic Insights by CMR. Int J Med Sci 2015; 12(5):378-386. doi:10.7150/ijms.11224. Available from http://www.medsci.org/v12p0378.htm